Nerves and Arteries of the Lower limb

the dorsal root has…

only sensory neurons

the ventral root has…

only motor neurons

the trunk of the spinal nerve has…

both motor and sensory neurons

the dorsal and ventral ramus of the spinal nerves have…

both motor and sensory neurons

the lumbar plexus is from…

T12, L1-L4

what does the lumbar plexus innervates

• anterior thigh

• medial thigh

what does the lumbar plexus branch off into

• femoral nerve

• obturator nerve

the femoral nerve is from which ventral rami?

L2-L4

describe the femoral nerve

• from ventral rami L2-L4

• superficial to iliacus muscle

• runs deep to inguinal ligament to enter anterior thigh

what does the femoral nerve innervate

• all of the anterior thigh muscles

  • rectus femoris

  • vastus lateralis

  • vastus intermedius

  • vastus medialis

  • Sartorius

• the iliacus

• half of the pectineus

where is femoral nerve relative to other structures

it is the most lateral structure

identify the femoral nerve

most lateral structure, not gummy

describe the obturator nerve

• from ventral rami levels L2-L4

• runs medial to psoas major

• enters medial thigh through obturator foramen

what does the obturator nerve innervate

• medial thigh

  • pectineus

  • adductor longus

  • adductor brevis

  • adductor magnus

  • gracilis

describe where obturator nerve is relatively

it is sandwiched between adductor longus and brevis

the sacral plexus innervates the…

• gluteal region

• posterior thigh

• anterior leg

• posterior leg

• lateral leg

• foot

describe the sacral plexus

• L4-S4

• located in the posterior pelvis

describe the superior gluteal nerve

• exists pelvis through greater sciatic foramen

• superior to piriformus

• runs between gluteus medius and minimus

• extends to tensor fascia latae

what does the superior gluteal nerve innervate

• gluteus medius

• gluteus minimus

• tensor fascia lata

describe the inferior gluteal nerve

• exists pelvis through the great sciatic foramen

• runs inferior to piriformis

• extends only to gluteus maximus

describe the sciatic nerve

• exists the pelvis through the great sciatic foramen

the obturator canal vs greater sciatic foramen innervation

• obturator

  • medial innervation

• greater sciatic foramen

  • posterior leg

describe the sciatic nerve

• L4-S3

• exists the pelvis through the greater sciatic foramen

• inferior to piriformis muscle

what does the sciatic nerve branch off into

• tibial nerve

• common fibular nerve

what does the sciatic nerve innervate

nothing

• the tibial nerve and common fibular nerve is what innervates

describe the tibial nerve relative to the common fibular nerve

• more medial

• superficial to the popliteal fossa

what does the tibial nerve branch off into

• lateral plantar nerve

• medial plantar nerve

what does the tibial nerve innervate

• the posterior leg

  • superficial

    • gastrocnemius

    • soleus

    • plantaris

  • deep

    • popliteus

    • tibialis posterior

    • flexor digitorum longus

    • flexor hallucis longus

• the posterior thigh

  • semitendinosus

  • semimembranosus

  • biceps femorous long head

describe where the medial and lateral plantar nerves are relative

• occurs deep to the abductor hallucis

what does the medial plantar nerve innervate

• abductor hallucis

• flexor digitorum brevis

what does the lateral plantar nerve innervate

• abductor digiti minimi

describe the common fibular nerve relative to others

• more lateral than the tibial nerve

• wraps around the neck of the fibula

what does the common fibular nerve branch off into

• superficial fibular nerve

• deep fibular nerve

what does the common fibular nerve innervate

• posterior thigh

  • biceps femoris short head

where is the superficial fibular nerve

• in between fibularis longus and brevis

• continues onto the dorsum of the foot for cutaneous sensory innervation

what area does the superficial nerve innervate

dorsum of the foot

what does the superficial nerve innervate

• lateral leg

  • fibularis longus

  • fibularis brevis

what does the deep fibular nerve innervate

• anterior leg

  • tibialis anterior

  • extensor digitorum longus

  • extensor hallucis longus

• dorsum of the foot

  • extensor digitorum brevis

  • extensor digitorum brevis

where is the deep fibular nerve relative to others

• travels between the tibialis anterior and extensor hallucis longus

what cutaneous area does the deep fibular nerve innervate

the flip flop area

what’s foot drop and what does it cause

damage to the common fibular nerve

• damage to the lateral and anterior compartments of the leg/foot

  • unable to dorsiflex the foot

  • unable to extend the toes

  • unable to evert the foot

  • anasthesia in the dorsum of the foot

what kind of inabilities would someone have with damage to the deep fibular nerve

• damage to anterior leg

  • damage to dorsiflex the foot

  • damage to extend the toes

describe the journey of the artery from the heart

• aortic arch

• descending thoracic aorta

• abdominal aorta

describe the branching from the abdominal aorta

• left of right common iliac artery

  • external iliac artery

  • internal iliac artery

briefly describe where the internal and external iliac artery are relatively

• internal iliac artery

  • towards the pelvic region

  • more medial

• external iliac artery

  • towards the lower limb

  • more lateral

what does the internal iliac artery branch off into

• obturator artery

• superior gluteal artery

• inferior gluteal artery

describe the superior gluteal artery

• superior to the piriformis

• travels along with the superior gluteal nerve

describe the inferior gluteal artery

• inferior to the piriformis

• travels along with the inferior gluteal nerve

what does the external iliac artery branch off into

• after passing the inguinal ligament, external iliac artery branches into

  • femoral artery

  • deep femoral artery

• after going through adductor hiatus, femoral artery branches into

  • popliteal artery

• popliteal artery branches into either

  • posterior tibial artery

    • fibular artery

    • lateral plantar artery

    • medial plantar artery

  • anterior tibial artery

    • dorsalis pedis artery

external iliac artery passes deep to the ____ and becomes ____

external iliac artery passes deep to the inguinal ligament and becomes femoral artery

describe the femoral artery

• travels in the anterior thigh deep to the sartorius

• goes through the adductor hiatus in adductor magnus

femoral nerve passes through ____ and becomes ____

femoral nerve passes through adductor hiatus in adductor magnus and becomes popliteus artery

describe deep femoral artery

• non terminal branch off femoral artery

• branches laterally from the femoral artery

the popliteal artery passes ______ to become either ____ or _____

the popliteal artery passes behind the knee within the popliteal fossa to become either anterior and posterior tibial artery

the mnemonic for the structures behind the popliteal fossa is…

AViaTioN

• popliteal Artery

• popliteal Vin

• Tibial Nerve

the popliteal artery will branch to become either…

• posterior

  • posterior tibial artery

  • fibular artery

• anterior

  • anterior tibial artery

the anterior tibial artery will…

loop around the front to the anterior of the leg along with the deep fibular nerve

the anterior tibial artery will cross the ____ to become _____

the anterior tibial artery will cross the ankle to become dorsalis pedis artery

the posterior tibial artery will…

run along MEDIALLY with the tibial nerve and go through the tarsal tunnel

the fibular artery will…

run along LATERALLY to the lateral compartments of the leg (fibularis longus and brevis)

the posterior tibial artery will become…

• lateral plantar artery

• medial plantar artery

all the names of the veins are the same as arteries except they…

• carry deoxygenated blood

• travel in the opposite direction (towards the heart)

the two superficial veins are…

• greater saphenous vein

• lesser saphenous vein

describe the greater saphenous vein

• longer

• is more medial and will drain into the femoral vein

describe the lesser saphenous vein

• shorter

• is more lateral and will drain into the popliteal vein